%0 Journal Article
%T Measuring the quality of dying and death in advanced cancer: Item characteristics and factor structure of the Quality of Dying and Death Questionnaire
%A Anne Rydall
%A Camilla Zimmermann
%A Gary Rodin
%A Isuri Weerakkody
%A Kenneth Mah
%A Lucy Liu
%A Samantha Fernandes
%A Sarah Hales
%A Sigrun Vehling
%J Palliative Medicine
%@ 1477-030X
%D 2019
%R 10.1177/0269216318819607
%X Ensuring a good death in individuals with advanced disease is a fundamental goal of palliative care. However, the lack of a validated patient-centered measure of quality of dying and death in advanced cancer has limited quality assessments of palliative-care interventions and outcomes. To examine item characteristics and the factor structure of the Quality of Dying and Death Questionnaire in advanced cancer. Cross-sectional study with pooled samples. Caregivers of deceased advanced-cancer patients (N£¿=£¿602; mean ages£¿=£¿56.39¨C62.23£¿years), pooled from three studies involving urban hospitals, a hospice, and a community care access center in Ontario, Canada, completed the Quality of Dying and Death Questionnaire 8¨C10£¿months after patient death. Psychosocial and practical item ratings demonstrated negative skewness, suggesting positive perceptions; ratings of symptoms and function were poorer. Of four models evaluated using confirmatory factor analyses, a 20-item, four-factor model, derived through exploratory factor analysis and comprising Symptoms and Functioning, Preparation for Death, Spiritual Activities, and Acceptance of Dying, demonstrated good fit and internally consistent factors (Cronbach¡¯s ¦Á£¿=£¿0.70¨C0.83). Multiple regression analyses indicated that quality of dying was most strongly associated with Symptoms and Functioning and that quality of death was most strongly associated with Preparation for Death (p£¿<£¿0.001). A new four-factor model best characterized quality of dying and death in advanced cancer as measured by the Quality of Dying and Death Questionnaire. Future research should examine the value of adding a connectedness factor and evaluate the sensitivity of the scale to detect intervention effects across factors
%K Quality of dying and death
%K advanced cancer
%K palliative care
%K end-of-life care
%K factor analysis
%K questionnaires
%U https://journals.sagepub.com/doi/full/10.1177/0269216318819607